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Androgen receptor expression

Prognostic value in locally advanced squamous cell carcinoma of the head and neck

Androgenrezeptor-Expression

Prognostische Bedeutung beim lokal fortgeschrittenen Plattenepithelkarzinom der Kopf-Hals-Region

Strahlentherapie und Onkologie volume 189, pages 849–855 (2013)Cite this article

An Erratum to this article was published on 19 February 2014

Abstract

Background and purpose

This study investigated the prognostic value of androgen receptor (AR) expression of tumor cells in patients treated with surgery and subsequent radio(chemo)therapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN).

Material and methods

The impact of AR and 11 additional factors on locoregional control (LRC), metastases-free survival (MFS), and overall survival (OS) was retrospectively studied in 163 patients with nonmetastatic stage III/IV SCCHN. Additional factors included age, gender, ECOG performance status, pre-radiotherapy (pre-RT) hemoglobin levels, tumor site, histologic grade, T category, N category, HPV status, extent of resection, and concurrent chemotherapy.

Results

On multivariate analysis, improved LRC was significantly associated with pre-RT hemoglobin levels ≥ 12 g/dl (risk ratio [RR] 2.22; 95 % confidence interval [CI] 1.19–4.13; p = 0.013), tumor site (RR 1.39; 95 % CI 1.14–1.70; p = 0.001), lower T category (RR 1.67; 95 % CI 1.18–2.44; p = 0.003), and lower N category (RR 4.18; 95 % CI 1.90–10.55; p < 0.001). Improved MFS was associated with AR expression (RR 2.21; 95 % CI 1.01–5.41; p = 0.048), better ECOG performance status (RR 3.19; 95 % CI 1.50–7.14; p = 0.003), lower T category (RR 2.24; 95 % CI 1.47–3.65; p < 0.001), and lower N category (RR 5.33; 95 % CI 2.07–16.63; p < 0.001). OS was positively associated with AR expression (RR 1.99; 95 % CI 1.06–4.00; p = 0.032), better ECOG performance status (RR 2.20; 95 % CI 1.20–4.09; p = 0.010), pre-RT hemoglobin levels ≥ 12 g/dl (RR 2.13; 95 % CI 1.19–3.82; p = 0.012), lower T category (RR 1.81; 95 % CI 1.30–2.62; p < 0.001), and lower N category (RR 3.41; 95 % CI: 1.65–7.80; p < 0.001).

Conclusion

Tumor cell expression of AR was an independent prognostic factor for MFS and OS and should be considered in future prospective trials.

Zusammenfassung

Hintergrund und Ziel

In dieser Studie wurde die prognostische Bedeutung der Tumorzellexpression des Androgenrezeptors (AR) bei Patienten mit einem lokal fortgeschrittenen Plattenepithelkarzinom der Kopf-Hals-Region (SCCHN) untersucht, die eine Operation mit nachfolgender Strahlentherapie oder Radiochemotherapie erhalten hatten.

Material und Methoden

Der Einfluss der AR-Expression sowie 11 weiterer Faktoren auf die lokoregionale Kontrolle (LRC), das metastasenfreie Überleben (MFS) und das Gesamtüberleben (OS) wurde retrospektiv an 163 Patienten mit einem nichtmetastasierten SCCHN im Stadium III/IV untersucht. Weitere Faktoren waren Alter, Geschlecht, Allgemeinzustand, Hämoglobinwert vor Bestrahlung (pre-RT), Tumorlokalisation, histologisches Grading, T-Kategorie, N-Kategorie, HPV-Status, Resektionsausmaß und simultane Chemotherapie.

Ergebnisse

In der Multivarianzanalyse war eine bessere LRC mit Hämoglobinwerten vor Bestrahlung ≥ 12 g/dl (Risk Ratio [RR] 2,22; 95 %-Konfidenzintervall [KI] 1,19–4,13; p = 0,013), der Tumorlokalisation (RR 1,39; 95 %-KI 1,14–1,70; p = 0,001), einer niedrigeren T-Kategorie (RR 1,67; 95 %-KI 1,18–2,44; p = 0,003) sowie einer niedrigeren N-Kategorie (RR 4,18; 95 %-KI 1,90–10,55; p < 0,001) assoziiert. Ein besseres MFS war mit AR-Expression (RR 2,21; 95 %-KI 1,01–5,41; p = 0,048), besserem Allgemeinzustand (RR 3,19; 95 %-KI 1,50–7,14; p = 0,003), einer niedrigeren T-Kategorie (RR 2,24; 95 %-KI 1,47–3,65; p < 0,001) sowie einer niedrigeren N-Kategorie (RR 5,33; 95 %-KI 2,07–16,63; p < 0,001) assoziiert. Ein besseres OS war mit einer AR-Expression (RR 1,99; 95 %-KI 1,06–4,00; p = 0,032), besserem Allgemeinzustand (RR 2,20; 95 %-KI 1,20–4,09; p = 0,010), Hämoglobinwerten pre-RT ≥ 12 g/dl (RR 2,13; 95 %-KI 1,19–3,82; p = 0,012), einer niedrigeren T-Kategorie (RR 1,81; 95 %-KI 1,30–2,62; p < 0,001) sowie einer niedrigeren N-Kategorie (RR 3,41; 95 %-KI 1,65–7,80; p < 0,001) assoziiert.

Schlussfolgerung

Die Tumorzellexpression von AR war ein unabhängiger Prognosefaktor für das metastasenfreie Überleben und das Gesamtüberleben und sollte in zukünftigen prospektiven Studien berücksichtigt werden.

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Compliance with ethical guidelines

Conflict of interest. D. Rades, N.D. Seibold, S.E. Schild, M.P. Gebhard, and F. Noack state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

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Affiliations

  1. Department of Radiation Oncology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany

    D. Rades M.D. & N.D. Seibold

  2. Department of Radiation Oncology, Mayo Clinic Scottsdale, Scottsdale, AZ, USA

    S.E. Schild

  3. Institute of Pathology, University of Lübeck, Lübeck, Germany

    M.P. Gebhard & F. Noack

Authors
  1. D. Rades M.D.
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  2. N.D. Seibold
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  3. S.E. Schild
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  4. M.P. Gebhard
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  5. F. Noack
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Corresponding author

Correspondence to D. Rades M.D..

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00066-013-0544-6.

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Rades, D., Seibold, N., Schild, S. et al. Androgen receptor expression. Strahlenther Onkol 189, 849–855 (2013). https://doi.org/10.1007/s00066-013-0389-z

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Keywords

  • Head and neck neoplasms
  • Radiotherapy
  • Radiochemotherapy
  • Androgen-receptor expression
  • Treatment outcome

Schlüsselwörter

  • Kopf-Hals-Tumore
  • Strahlentherapie
  • Radiochemotherapie
  • Androgenrezeptor-Expression
  • Behandlungsergebnis